Membership Application

Please fax completed application to 519.744.3587

I hereby apply for membership in the

German Canadian Business and Professional Association of Kitchener-Waterloo

If accepted, I agree to conform to the Rules and Regulations according to the Bylaws of the Association,

as long as I remain a member.

Name : _____________________________________ Spouse : _______________________

Address : __________________________________________________________________

City: _____________________________________  Postal Code : _______________

Tel (Residence)  : __________________    Business : __________________

Fax (Residence) : __________________    Business : __________________

e-mail  (Res.) : _______________________________  Bus : _________________________

Business or Profession : ____________________________________________________

Company Name : _________________________________________________________

Company Address : _______________________________________________________

City : _____________________________________       Postal Code : _______________

Signature : __________________________________________ Date : _______________

Membership proposed by : ____________________________________________________

Seconded by : ______________________________________________________________

This application for Membership is subject to the approval of the Board of Directors.

Application accepted this ________ day of ____________, 200____